What is plantar fasciitis?

Plantar fasciitis refers to inflammation and pain involving the long elastic structure under the foot responsible for maintaining the arch and preventing the foot from flattening when we walk. In ‘fasciitis’ the body is trying to repair the injury and has gone into ‘overdrive’ because of one or more factors that may be aggravating recovery.

Identifying plantar fasciitis symptoms

The common factors associated with or the cause plantar fasciitis include:

Tight muscles and/or fascia

Referred pain from irritable areas in the muscle called trigger points

Excessive standing or walking on hard surfaces

Excessive weight

A specific injury from a fall, running or sporting or working activity

Poor unstable footwear

Abnormal biomechanical function such as excessive pronation or poor shock absorption from a high arched foot

Other inflammatory arthritic conditions such as rheumatoid arthritis

Where it occurs

Plantar fasciitis occurs at two specific sites:

Insertion of the plantar fascia into the heel bone

Mid portion of the plantar fascia

Treatment

The initial treatment for both locations are similar:

Calf and ankle stretching

Self-massage

Short course of anti-inflammatory medication

Rigid strapping

Night splint for six weeks

Prescription cushioned orthoses

Change in footwear (if required)

Dry needling/acupuncture

Ankle block and cortisone injection

Further treatment

It is when these common treatments are ineffective that further options are required as the injured fascia has morphed into a different condition referred to as ‘fasciosis’. This is when the body has ‘given up’ on healing the injured site. This is when treatment is to encourage inflammation to jumpstart the body’s healing and repair processes. Treatment can include:

If you don’t respond to any form of treatment then surgical release of the fascia needs to be discussed with your surgeon.

Improvements and healing

The plantar fascia has a relatively poor blood supply like most ligamentous structures, so it will take some time for the condition to settle. Typically you can expect 50-60% improvement in the first four weeks after treatment and things improve week by week over the next 2-3 months with “the tincture of time”.